A couple has delivered a 28-week fetal demise. Which of the following nursing actions are appropriate to take?Select one that doesn't apply

Correct Answer: C

Rationale: In this scenario, option C, "Encourage the couple to try to get pregnant again in the near future," is not an appropriate nursing action. It is crucial to provide sensitive and empathetic care to a couple who has experienced a fetal demise at 28 weeks. Encouraging them to try to get pregnant again in the near future can be emotionally insensitive and could potentially hinder their grieving process. Option A, "Swaddle the baby in a baby blanket," may provide the couple with the opportunity to hold and say goodbye to their baby, facilitating the grieving process. Option B, "Discuss funeral options for the baby," is important as it allows the couple to make decisions about honoring their baby's memory and provides closure. Option D, "Ask the couple whether they would like to hold the baby," is also appropriate as it gives the couple a chance to bond with their baby and create memories. In an educational context, it is vital for healthcare providers to be well-versed in providing compassionate care to individuals experiencing pregnancy loss. Understanding the emotional complexities involved and knowing how to support individuals through the grieving process is essential in delivering holistic care. By choosing appropriate actions and responses, healthcare providers can help facilitate healing and promote emotional well-being during such challenging times.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Uterine atony. Uterine atony is a condition where the uterus fails to contract after childbirth, leading to excessive postpartum bleeding. In the case of a macrosomic baby and a prolonged labor, there is an increased risk of uterine atony due to the prolonged stretching of the uterus and potential exhaustion of uterine muscles. Option B) Hypoprolactinemia is incorrect because it refers to low levels of prolactin, a hormone responsible for milk production. While this can affect breastfeeding, it is not directly related to the scenario of postpartum complications following a macrosomic birth. Option C) Infection is a general risk after any labor and delivery but is not specifically linked to macrosomia or prolonged labor. Option D) Mastitis is an inflammation of the breast tissue commonly associated with breastfeeding. While it can occur postpartum, it is not directly related to the scenario of macrosomia and uterine atony. Educationally, understanding the potential complications following a macrosomic birth is crucial for healthcare providers caring for postpartum women. Monitoring for uterine atony is essential to prevent severe postpartum hemorrhage and ensure the woman's well-being post childbirth. This knowledge helps in providing timely interventions and appropriate care to prevent and manage complications effectively.

Correct Answer: B

Rationale: Rationale: Consuming grapefruit should be avoided by a woman taking Paxil (paroxetine) for postpartum depression to prevent a drug/food interaction. Grapefruit contains compounds that can interfere with the enzyme responsible for metabolizing Paxil, leading to increased levels of the drug in the body and potentially causing adverse effects. Alcohol is not recommended during postpartum depression treatment due to its depressive effects on the central nervous system and potential interactions with medications, but it is not specifically contraindicated with Paxil like grapefruit. Milk and cabbage do not have significant interactions with Paxil that would require them to be avoided. In fact, maintaining a healthy diet that includes dairy products and vegetables like cabbage can be beneficial for overall health and well-being during the postpartum period. Educational Context: Understanding potential drug and food interactions is crucial for healthcare providers and patients to ensure the safe and effective use of medications. In the context of postpartum care, addressing postpartum depression is vital for the well-being of both the mother and the baby. Educating women about dietary considerations when taking medications like Paxil can help prevent adverse effects and optimize treatment outcomes.

Correct Answer: B

Rationale: The correct answer is B) Encourage the woman to breastfeed frequently. Rationale: Encouraging the woman to breastfeed frequently is the appropriate nursing intervention for mastitis because it helps to empty the affected breast regularly, preventing milk stasis and promoting drainage of the infection. Continued breastfeeding also helps maintain milk supply and does not harm the baby. Option A) Advising the woman to apply ice packs to her breasts is incorrect because cold therapy is not recommended for mastitis as it can worsen milk stasis and decrease milk flow. Option C) Informing the woman that she should wean immediately is incorrect as breastfeeding should continue to help resolve mastitis and maintain breastfeeding benefits for both mother and baby. Option D) Directing the woman to notify her pediatrician as soon as possible is incorrect because the primary healthcare provider to involve in this situation is the obstetrician or a lactation consultant who can provide guidance on managing mastitis. Educational Context: It is crucial to educate healthcare providers and mothers about the importance of proper management of mastitis to avoid complications and maintain breastfeeding. Encouraging frequent breastfeeding, ensuring proper latch and positioning, applying warm compresses before feeding, and ensuring adequate rest and hydration are key components of managing mastitis effectively. Engaging in continuing education and staying updated on evidence-based practices in lactation support is essential for healthcare professionals working with breastfeeding mothers.

Correct Answer: D

Rationale: The correct answer is D) Candida albicans. In the scenario described, thrush in the baby and breast infection in the mother suggest a fungal infection caused by Candida albicans. This organism commonly causes thrush in infants and can be passed to the mother during breastfeeding, leading to a breast infection. Option A) Staphylococcus aureus is a common bacterium that can cause skin infections, but it is not typically associated with thrush or fungal infections. Option B) Streptococcus pneumoniae is a bacterium that causes respiratory infections like pneumonia and is not typically involved in thrush or breast fungal infections. Option C) Escherichia coli is a bacterium found in the gut and is associated with gastrointestinal infections, not fungal infections like thrush. Understanding postpartum body changes, including breastfeeding-related complications like thrush and breast infections, is crucial for healthcare providers to effectively support and treat postpartum women. Recognizing the specific organisms involved helps in providing appropriate management and care for both the mother and baby.